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Hemodynamics in coronary arteries with overlapping stents

Citation

Rikhtegar, F and Wyss, C and Stok, KS and Poulikakos, D and Muller, R and Kurtcuoglu, V, Hemodynamics in coronary arteries with overlapping stents, Journal of Biomechanics, 47, (2) pp. 505-511. ISSN 0021-9290 (2014) [Refereed Article]

Copyright Statement

Copyright 2013 Elsevier Ltd. All rights reserved.

DOI: doi:10.1016/j.jbiomech.2013.10.048

Abstract

Coronary artery stenosis is commonly treated by stent placement via percutaneous intervention, at times requiring multiple stents that may overlap. Stent overlap is associated with increased risk of adverse clinical outcome. While changes in local blood flow are suspected to play a role therein, hemodynamics in arteries with overlapping stents remain poorly understood. In this study we analyzed six cases of partially overlapping stents, placed ex vivo in porcine left coronary arteries and compared them to five cases with two non-overlapping stents. The stented vessel geometries were obtained by micro-computed tomography of corrosion casts. Flow and shear stress distribution were calculated using computational fluid dynamics. We observed a significant increase in the relative area exposed to low wall shear stress (WSS<0.5 Pa) in the overlapping stent segments compared both to areas without overlap in the same samples, as well as to non-overlapping stents. We further observed that the configuration of the overlapping stent struts relative to each other influenced the size of the low WSS area: positioning of the struts in the same axial location led to larger areas of low WSS compared to alternating struts. Our results indicate that the overlap geometry is by itself sufficient to cause unfavorable flow conditions that may worsen clinical outcome. While stent overlap cannot always be avoided, improved deployment strategies or stent designs could reduce the low WSS burden.

Item Details

Item Type:Refereed Article
Keywords:stent overlap, thrombosis, hemodynamics, wall shear stress, restenosis
Research Division:Engineering
Research Group:Biomedical engineering
Research Field:Biomechanical engineering
Objective Division:Expanding Knowledge
Objective Group:Expanding knowledge
Objective Field:Expanding knowledge in engineering
UTAS Author:Stok, KS (Dr Kathryn Stok)
ID Code:133194
Year Published:2014
Web of Science® Times Cited:35
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-06-18
Last Modified:2019-07-29
Downloads:0

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